1. Colorado Title X Family Planning Program Cost Analysis/Rate Setting Part 1: Determining Cost

2. Performing a cost analysis/cost setting activity is a Colorado Title X requirement that demonstrates how vendor sliding fee scales are developed. “Charges must be based on a cost analysis of all services provided by the project.” - US Department of Health and Human Services, Office of Population Affairs 2014-2015 Cost Analysis/Cost Setting

3. WHAT IS COST? Introduction

4. Your facility should have access to financial statements/reports monthly – For example, a profit and loss statement (P&L) is a historic look at a business; what happened in the past Cost is everything (related to Title X services) – Rent – Personnel (wages, benefits), full time, part time, contractors – Insurance – Supplies – Lab – Medications – In-Kind Contributions – Etc. What is Cost? *We know that some of you provide other services in addition to Title X, so it is important to keep track of all expenses. It may be necessary to make estimates and document the rationale for separating out those expenses.

5. COMMON COSTS

6. Common Costs Operating Expenses Professional Services Personnel Costs Provider Specific Costs Ancillary Services Pharmacy Community Outreach and Education Other Costs

7. Advertising* Education/Training (Publications/Journals) Operations – Dues and subscriptions – Computers and technology costs: software, support, other, copier lease, etc. – Billing – Equipment leases – Office liability insurance – Postage, delivery, shipping – Supplies: marketing, medical, office – Telephone – Answering service – Utilities: gas and electricity – Rent – Internet – Housekeeping/cleaning service – Waste management – Insurance: business, liability/office *Advertising may be classified as Marketing or Community Outreach/Education Operating Expenses

8. Professional Services Accounting Billing Audit Legal Consulting

9. Personnel Costs Staff – Management and Non-management – Exempt and Non-Exempt – Not providers, not revenue producers Allocation of staff – Identify all individuals who spend any amount of time during the year on Family Planning related services – Determine the tasks each staff member performs throughout the year using the previously mentioned common costs Identify all costs, specific to each staff member – Wages – Benefits (health insurance, retirement, medical reimbursement) – PTO Accrual – Workers’ compensation – Continuing education – Etc.

10. Time Study - Family Planning Services Determine FTE Percent Identify time span to measure (daily, weekly, monthly) Delineate tasks performed by the individual Example: 0.30 WIC 0.40 Family Planning 0.20 Immunizations 0.10 Other 1.00 FTE

11. Provider Specific Costs Wages Bonuses Benefits PTO Accrual Laundry services Vehicle expenses Supplies (if specific to the provider) Cell phone CME, including travel Insurance: malpractice, health, life, disability Licensure & certifications Payroll tax Business advancement 401K Labcoat Etc.

12. Ancillary Services Lab Radiology Pharmacy – Medication and Device Expense – Medication Administration Fees – In house or contract pharmacist, if applicable – 340B Management

13. Community Outreach & Education Events (exhibit booth rentals, health fairs, conferences) Travel Costs Marketing & Collateral Materials Supplies

14. Other Costs In-Kind Contributions (such as volunteering time for flu shot clinics) Indirect or uncategorized costs Depreciation

15. DETERMINATION OF COST

16. Determination of Cost Use most recent fiscal data available – Use 12 consecutive months (fiscal or calendar year) Your agency must be able to identify expenses related to Family Planning services – Expenses related to other programs or services may not be counted in determining your Title X costs

17. SAMPLE COST ANALYSIS

18. Cost Analysis Template Each agency will be different – Different number of providers – Different number of locations – Different types of services – Different budget categories The key is to be as detailed and consistent as possible